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r LAND USE PERMIT APPLICATION —Burnett County, WIcr <br /> Applicant Complete All Sections Below This Line o c <br /> O. <br /> Permit Types and Fees:(Please,check appropriate boxes) d 1. <br /> Dwelling/Principal Structure $300 Addition/Alteration to Dwelling/Principal Structure $200 "� <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 O <br /> Accessory Structure(Garage,Shed,etc.) $150' Addition/Alteration to Accessory Structure $150 1 <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 '4�) r <br /> .. Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 o +Gvlik <br /> i: <br /> y Driveways/&Campground Structures $125— WI State Statute 59.692(1v)Structures $350 r- 1 <br /> o tV! <br /> Filling/Grading $150 Boathouse $500 <br /> Six Month Camping Unit(One Per Year) $100 Permit Extension(1Year Extension-Allowed Once) $100 (1 <br /> *NOTE:After-the-fact permits(permit aqui red after construction has begun)may cost up to three times the normal fee. 5 <br /> *Communication Towers&Signs require a different application form;see corresponding application,and fees. ro <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. r- 0 ' <br /> o z• `....... <br /> Property Owner's Name: 1\ ^v,r \O.\1 4. k.).a V f'\\\ k p <br /> 5 oo <br /> Property Owner's Mailing Address: 3 0 a'1 �^d NA,N bq.n)G,ty U 54' '16 <br /> ' i.VA City State Zip g• n <br /> Property Site Address: 3()‘1.7 '-' 1-1wt 35 <br /> Contact's Telephone Number: 7 I S ID S(D 3 1 5 0 <br /> a <br /> Contact's Email: 'cYN girl , Y\ A © Q, Yin , C-10 wN <br /> Legal Description of Property: ciqo <br /> Section#: acA Town#: 4 1 N Range#: I Lc. W Town of: Sva‘Sg • <br /> *Attach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. <br /> Tax ID#(1-5 digit number;found on tax statement): 02 a09z, 'J T <br /> Proposed Use of Structure/Addition: t 12 & y\;,r'. W 0,\\ ,h ,Qct;p 0 <br /> Anticipated Start Date: Mci \ , a(')A.© (H�e/Cabin:Commercial Business;Bedroom;Deck:etc) ° E, <br /> Building Contractor: 'C\U A Sewer Installer: IN OWL H ,) <br /> V <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY ' -1 <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: U' <br /> z Vt <br /> pzi <br /> 00 <br /> - Fee Rec:/ /c2.� <br /> Check#: ((1$7 <br /> Date of staff site visit: / 0i Ini , sof site visit staff: <br /> ��� 7 <br /> 4 . <br /> APPROVED BY LAND SERVICES OFFICIAL: �,/ <br /> DATE: _, <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF s m E° 3 5) <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT zf a o r...1 `Li di. <br /> Transcendent: - Page 1 of 4 ,L.' <br /> 3` o "'' <br /> Laserfische: Burnett County, WI Land Use Application —Rev 1/2019 _,-_-- _ . <br /> C.----- <br /> , <br /> z <br />